Is Full-Coverage Dental Insurance Worth It?
The top performers in our review are Delta Dental, the Gold Award winner; Guardian, the Silver Award winner; and Humana, the Bronze Award winner. Here’s more on choosing insurance to meet your needs, along with detail on how we arrived at our ranking of 10 dental insurance companies.
Many people ask themselves if dental insurance is worth it. Through our research for these dental insurance reviews we learned that if you attend preventive exams every six months, it is usually financially beneficial. If you need additional procedures such as root canals, crowns or fillings, then you will realize even more cost saving by having a good dental insurance plan.
What Does Dental Insurance Cover?
Most full coverage dental insurance plans will cover two preventive maintenance visits per year without requiring a deductible payment. Most require a $50 deductible per person, per year to help cover costs beyond your preventive exams. If you need work done, most plans will cover a part of the costs. We looked at root canals specifically and found that the majority of dental plans will cover about half the cost, which may not seem like a lot, but paying half is better than paying upfront for an $800 root canal. However, keep in mind that most insurance policies, depending on your plan, top out at about $1000 to $1500 per year. Using conservative estimates that might be one or two root canals. If you need extensive work done you might have to pay the remaining amount out of pocket.
There are few procedures that most insurance companies will not cover or only provide a discount for. Most individual dental insurance plans do not cover what might be considered cosmetic procedures such as tooth-colored fillings on molar or bicuspid teeth, dental implants or adult cosmetic orthodontics. The majority of dental companies will also limit how often certain appliances can be replaced and, in most cases, will not replace lost items. The limitations are published in the disclosures and contracts for the plan, many of which you can peruse online. Keep in mind that a new dental insurance plan is not going to cover an emergency you are experiencing right now; most have a waiting period of six to 12 months for major work. (However, some will waive the waiting period if you recently had dental insurance.) Dental groups that offer dental discount plans will let you use your benefits right away, but they only provide a discount and not full coverage. Full coverage plans will however cover your initial evaluation so you can start planning your dental procedures.
About Our Dental Insurance Reviews
While we conducted extensive research, we cannot tell you exactly what your new dental plan premium will be or what it will cover. Premiums vary by zip code, age, plan type and other factors. Our reviews can tell you generally what to expect from the dental insurance companies we reviewed, but we cannot predict your exact situation. To calculate average premiums we gathered quotes from numerous areas across the nation; we chose zip codes from large metropolitan areas and from smaller cities of around 150K. We looked for premium rates for one, two and three persons. We made note of the lowest and highest premiums quoted and excluded dental discount plans and preventive-only plans. The sample terms and conditions are common scenarios, but again, these vary depending on the plans available in your area.
In general the dental insurance companies at the top of our review list provide a range of plan options to numerous areas of the country. We also considered average yearly preventive care costs across numerous zip codes and compared that number to possible yearly premium costs. This helps predict whether the premium costs would, on average, be less than the cost of preventive care paid out of pocket. Keep in mind that co-pays and other small fees might also determine whether you will break even by paying for dental insurance, but our numbers can give you a general idea of what you can expect. It was not surprising to learn that those who charge a higher premium may cover more and those with a lower premium might cover less. This means that if you pay more monthly you might receive more complete coverage, and if you pay less per month you might be expected to pay a bit more during the time of treatment. So you'll need to decide whether you want to pay more per month or make up a bit of the difference when you visit your dentist.
What Kind of Dental Plans Are Available?
Most dental insurance companies will offer a variety of plans in your area. You can find plans ranging from affordable discount plans to what might be considered "gold-level" plans. Here are a few types of plans you may choose from:
Dental Discount Plans
These are not full-coverage plans but do provide discounts to most common procedures. Discount plans usually only cost about $10 per month per person, and benefits can be used immediately.
These low-premium plans may be suitable for those who do not usually need dental work done. These plans will help you cover preventive exams and cleanings. To learn more about why preventive care is important, see What Is Plaque?
Standard Individual Plans
This is likely the most popular plan type for individuals since it will cover most of the costs of preventive exams. Most will cover two exams, cleanings and X-rays per year and will partially cover additional work. There may or may not be a small exam copay.
These plans are similar to standard individual plans. However, many insurance companies will offer the benefit of a family deductible. While most dental plans require a $50 deductible per person, many will have a maximum family deductible of $150, which could be beneficial to those who need to insure more than three persons.
"Gold" or "Premium" Plans
Premiums for these plans will cost more but often may include a higher yearly payout rate, such as $1500 rather than $1200. The plans may also allow more cleanings per year, such as one every four months rather than one per six months.
Other options to ask about include add-on plans for things like assisting with children orthodontics or adult implants. We've put together more information about finding the best dental insurance and how to obtain a quote in the article Tips for Finding Affordable Dental Insurance.
No matter which type of plan you choose, we recommend that you carefully review your contract so you know exactly what your insurance will cover. Additionally, in most cases your dentist's office will be familiar with what your insurance may or may not cover. Since many dental offices will require you to pay the estimated uncovered balance upfront, you will need to make sure you know what that is in advance so you can plan your budget. If you cannot cover the remaining balance you may want to ask if your dentist provides financing.
If you are changing insurance and want to continue with your current dentist, you can visit the websites of insurance companies you are thinking about signing up with and search to see if your dentist accepts the new type of insurance. However, sometimes these search results aren't updated or only show offices seeking new patients, so you'll want to verify by calling your dental office.
How to Estimate Dental Expenses
Estimating your possible dental costs may help you decide whether dental insurance would be financially beneficial. Dental insurance companies will show you a quote online so you can easily see what your premiums might be. You may want to compare your estimated yearly premiums to the cost of a year of procedures you want to have done. You can estimate how much your dental expenses might be either by talking with your dentist, or by researching costs online. You can use the estimates to help you decide whether you should pay out of pocket or plan your dental expenses based on your insurance coverage. Two resources for looking up procedure costs are The Fair Health Consumer Organization and the Guardian Insurance website. Estimated costs are sorted by zip code and will show a low and high rate so you can see a range of what a procedure may cost in your area.
Other factors can affect your yearly dental expenses as well. Unfortunately, senior premiums are usually more and youth orthodontics may also cost more. Smokers are usually quoted higher premiums as well. Monthly premium rates vary greatly by region and area. We found that within the same insurance company rates may vary by as much as 30 percent depending on the zip code.
While some financial planners suggest dental insurance may not be worth paying for, we did the math to discover that it is usually worth it, provided you attend all of your allowable preventive exams and cleanings. We also learned that if you need any type of work such as a root canal or filling, you will definitely notice a cost savings. However, premiums vary greatly, not only by the type of plan, but by location and age. So you'll want to obtain a few quotes for insurance companies that provide coverage in your area. You'll also want to verify that your dentist accepts your chosen insurance before you sign up with a new provider. To learn more, visit our reviews and articles about dental insurance.